Bilateral horizontal gaze palsy in multiple sclerosis

Bilateral horizontal gaze palsies are rare. In this case report, we present a 28-year-old woman with bilateral horizontal gaze palsies due to involvement of both paramedian pontine reticular formations (PPRFs) by multiple sclerosis (MS) plaques.     

101例尿毒症相关性肺水肿的特殊护理措施

目的 探讨尿毒症相关性肺水肿的特殊护理措施。方法 对尿毒症相关性肺水肿的护理除常规护理措施外，应做到以下几点特殊护理：①密切观察血压、血氧饱和度、近期尿量变化；②有效控制血压；③采取不同的透析方式适时适量透析超滤、加强透析中的护理；④改善全身营养状况，防止肺部感染；⑤牢记护理程序体位-吸氧-血管扩张药-血液透析；⑥严格控制入量。结果 101例病人中抢救成功84例，死亡13例，自动出院3例。结论 采取治疗和特殊护理对抢救尿毒症相关性肺水肿患者有较好效果。     

分离肝细胞纯化培养方法的比较研究

目的 评价一种可提高肝细胞纯度和存活率的分离培养方法。方法 以体外两步胶原酶灌流法分离肝细胞,然后将其分成两组,对照组在接种培养前不经进一步处理,试验组则在应用适宜的Percoll梯度液离心纯化之后再行培养。藉台盼蓝拒染法比较两组肝细胞的存活率,采用MTT法动态比较两组肝细胞的增殖状态,在相差显微镜下观察细胞的纯度和形态。结果 未经进一步纯化处理的猪肝细胞存活率为90％±5％,鼠肝细胞存活率为80％±5％,两者纯度均约90％;经Percoll梯度液离心纯化后,其高活力肝细胞比率均提高至98％±2％,纯度可达99％以上。从开始接种到大部分肝细胞贴壁生长,试验组比对照组肝细胞的时间有所缩短。结论 用Percoll梯度液纯化新分离肝细胞,可提高肝实质细胞的活力与纯度。     

Negative inotropic effect of 3,6-dimethamidodibenzopyriodonium citrate (I-65) on guinea pig papillary muscles

The effects of 3,6-dimethamidodibenzopyriodonium citrate (I-65) on the contractile response of electrically paced guinea pig papillary muscles in vitro were studied. I-65 (0.1-300 mumol/L) decreased the contractile force and inhibited isoprenaline-induced restoration of the contractile response in papillary muscles rendered inexcitable by KCl 22 mmol/L. Both effects were concentration-dependent, and the IC50 were 36.0 and 7.3 mumol/L, respectively. I-65 antagonized the positive inotropic effects of Iso and CaCl2 in a non-competitive manner. Like verapamil, I-65 had a frequency-dependent negative inotropic effect, and delayed the recovery of post-rest potentiation. It is concluded that the negative inotropic effect of I-65 results not only from the reduction of Ca2+-influx through the sarcolemmal membrane, but also from the inhibition of Ca2+ translocation in the sarcoplasmic reticulum.     

Effectiveness of montelukast in the treatment of cough variant asthma.

BACKGROUND: Antileukotriene agents have been shown to be beneficial in chronic asthma. Although patients with cough variant asthma have cough with minimal wheezing and dyspnea, airway hyperresponsiveness from chronic inflammation is believed to be the underlying mechanism. OBJECTIVE: To evaluate the effectiveness of montelukast, a leukotriene receptor antagonist, in the treatment of cough variant asthma. METHODS: Fourteen patients with cough variant asthma participated in a randomized, double-blind, placebo-controlled trial with a 7- to 10-day baseline period and a 4-week treatment period with montelukast, 10 mg, or placebo daily. Inclusion criteria were (1) chronic cough with a duration of at least 4 weeks with minimal or no wheezing or dyspnea and (2) forced expiratory volume in 1 second of 50% to 85% of predicted and reversibility of 12% with use of an inhaled beta-agonist or forced expiratory volume in 1 second greater than 85% and positive methacholine challenge results. Patients fulfilled the minimum criteria for cough frequency and symptom scores for randomization. RESULTS: Eight patients received montelukast and 6 received placebo. The primary efficacy variable, mean percentage change from baseline in cough frequency, was significantly improved by the second week, and by the fourth week the mean percentage change from baseline was 75.7% for the treatment group and 20.7% for the placebo group. CONCLUSIONS: The leukotriene receptor antagonist montelukast seems to be effective in the treatment of cough variant asthma. Larger studies are recommended to confirm this effect.     

谈耳鼻喉科教学中多媒体技术的应用

多媒体教学技术应用于耳鼻喉科教学,具有直观性好、动态感强、信息量大等优点,能使教学信息直接、形象、具体、生动地展现给学生,让学生体会到学习的乐趣,是耳鼻喉科现代化教学的理想模式.     

消化道手术中医源性脾损伤的预防和处理

医源性脾损伤(iatrogenicsplenicinjury)通常是指处理脾脏邻近器官的手术时,由于手术操作、医疗器械使用不当或局部解剖变异所造成的脾脏损伤。在临床上因各种原因导致的医源性脾损伤并不罕见,而且一旦发生损伤将会引发手术时间延长、术中失血量增加、病人住院时间延长等一系列问题;有的尚须行无辜性脾切除,导致脾切除术后发生并发症的风险增加,不仅给病人带来痛苦,甚至危及其生命。因此,医源性脾损伤已成为外科领域值得关注的问题。1应尽力避免医源性脾损伤消化道手术中医源性脾损伤的发病情况国内外报道不尽相同。Cassar等[1]报告,近40%…     

急性缺血性脑血管疾病的药物序贯治疗

目的:探讨药物的序贯治疗对急性缺血性脑血管病的治疗效果。方法:随机分成去纤酶、奥扎格雷钠、盐酸丁格地尔序贯治疗组和使用肠溶阿斯匹林、复方丹参针对照组,治疗组和对照组在治疗前后作神经功能评估,患者的生活能力状态评价及脑循环血流变化的测定。结果:治疗组显效率76.1%,有效率8.7%,总有效率84.8%,对照组显效率23.5%,有效率14.7%,总有效率38.2%(P<0.05)。结论:药物序贯治疗急性缺血性脑血管病比常规治疗疗效显著。     

~3H-α-第二丁基对羟基苄醇在家兔体内的药物动力学研究

本文报道给家兔注入不同剂量的~3H-α-第二丁基对羟基苄醇,观察该药在其体内的药物动力学。结果表明,血中分布相快,消除相慢,消除半衰期T_1/1β为12h。经F值检验和理论计算值与实测值的契合程度比较,表明该药在兔体内的运转符合二室开放模型的动力学方程。     

米非司酮对妊娠中期胎儿心脏超微结构的影响

目的:探讨米非司酮对妊娠中期胎儿心脏超微结构的影响。方法:将计划引产孕妇随机分为两组:对照组(水囊组)10例,实验组(米非司酮+水囊)15例。实验组按孕龄分为实验Ⅰ组(10例,16~22周),实验Ⅱ组(5例,23~28周)。实验组口服米非司酮100mg,连服3天,行水囊引产,对照组只行水囊引产。胎儿娩出后取心肌组织进行样本制备,然后在电镜下观察组织的超微结构。结果:细胞肿胀、空化,细胞膜不完整,闰盘分离,部分细胞连接消失。细胞核多呈不规则形,核内染色质凝聚呈块状,部分细胞核空化,核周围可见脂褐素。大部分肌丝断裂,肌节结构消失,少数可辩残留肌节结构,其间可见少量核糖体,但各带结构不清。线粒体肿胀,高度空化,嵴断裂,细胞基质局部空化。毛细血管内皮细胞肿胀。心肌组织细胞的超微结构有改变,且孕龄越小,超微结构改变越明显。结论:米非司酮可以引发胎儿心脏的缺血缺氧性改变。